Provider Demographics
NPI:1083639314
Name:BAILEY, CHRISTOPHER J (LCSW)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:J
Last Name:BAILEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
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Mailing Address - Street 1:1115 WEBER STREET
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:LA
Mailing Address - Zip Code:70538-4124
Mailing Address - Country:US
Mailing Address - Phone:337-828-2550
Mailing Address - Fax:337-355-2335
Practice Address - Street 1:1014 W TUNNEL BLVD
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4050
Practice Address - Country:US
Practice Address - Phone:985-851-1717
Practice Address - Fax:985-868-3839
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2015-08-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA52681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1366641Medicaid
LA1366641Medicaid